Wednesday, May 28th

It was another slow morning, but this one was due more to the exhaustion that has been beating up both mom and dad. We arrived back at Children's Mercy at 10:30 am and quickly got updated on changes from last night and earlier this morning.

Nurse Phyllis is back and taking care of Kinley again today. She informed us that over the night Kinley's Ph and CO2 levels were good, but her O2 levels had dropped down into the 60s and 70s a few times. To help increase her O2 levels they increased the percentage of oxygen coming from the high frequency ventilator. Kinley's BP remained low last night, but they did not give her any hydrocortisone. Instead, the increased her dopamine setting from 15 to 17. Originally we were given the impression that 15 was the maximum dosage for dopamine, but we have now been told that they can go as high as 20 or even more in some cases.

As of this morning, but before we arrived, they had stopped Kinley's antibiotics because all of her cultures had come back negative. A surgical team came by to evaluate Kinley, but no date yet for surgery as she is still too unstable. Her most recent blood gas test was at 9:50 am and her results were Ph at 7.4, CO2 at 41 and O2 at 180. All great numbers. Keep up the good work Kinley!

We got another set of blood gases at 2 pm. Kinley's Ph and CO2 were good, but her O2 had dropped to 89. While this is a lower number than the previous result, it was not low enough to cause a huge concern and her treatment will remain the same for now. Speaking of blood gases, Kinley is trialing a new toy for the nurses and doctors. The new blood gas tester gives instant results and decreases the amount of blood loss at each test. Currently when the nurse runs a blood gas test, they take blood from Kinley in a syringe and take it to be processed in the lab and then the blood is discarded. The new blood gas tester takes blood from Kinley, tests it directly at her bedside and then cycles the blood back into Kinley so that she doesn't lose any blood. Since Kinley is just trialing the new machine they will not use any of its results to make decisions on Kinley's care. They will continue to do current blood gas tests on top of the new machine and then compare the results. So far the results from the new machine have not been as accurate as the current system.


New blood gas tester at Kinley's bedside.

At 5:15 pm Kinley was given a dose of morphine and versed (a sedative) since her heart rate was a little elevated. We could see Kinley trying to breathe over the ventilator again which means that she is not as comfortable as we would like to see her. Hopefully the meds will help her relax. (I think she gets the inability to relax from her mom.)

At 7 pm we got another blood gas test and the results were Ph 7.2, CO2 65 and O2 97. Since her CO2 was a little high they ordered a chest x-ray to check the placement of Kinley's tubes and also to see if there was any air in her stomach and/or intestines. They also decided to increase her vent settings to help decrease the CO2. At 7:40 pm Kinley was given another dose of morphine and versed since she was still trying to breathe over the ventilator. Hopefully once the CO2 comes down Kinley will not feel the need to try to breathe over the vent.

After the shift change we came back to visit and found that Noel is back again tonight to take care of Kinley. A bit of exciting news for us was that we were able to help care for Kinley a little. Up until now we have barely been able to touch Kinley for fear that we might upset her. Noel let Kathy check Kinley's temp and Kevin got to change Kinley's diaper!! We actually felt like real parents for a minute.

After we finished taking care of Kinley we received the results of another blood gas test. Her Ph was 7.32, CO2 was 60 and her O2 was 207. Her CO2 was a little high, but we are just going to wait and see if Kinley will respond to the changes that were made earlier. We also were informed that Kinley's x-ray came back with nothing out of the ordinary, which is always good news. It is getting pretty late here, so mom and dad are going to head home knowing that Kinley is in good hands here.